The Seductive (But Dangerous) Allure of Gabor Maté

Gabor Maté is a distinguished figure in the addiction field, the author of "In the Realm of Hungry Ghosts." Maté is revered for his humane medical work with inner-city drug addicts in Vancouver, centering on the Insite injection center (where users are given works to inject their own drugs) and Portland Hotel (Community Health) Society, which provides housing and lives, really, for the most downtrodden Vancouverites. Thank God there is such a service; bless Maté for his work there. (Disclosure: I visited and conducted workshops at Insite and PHS in January.)

Maté maintains a human communion with his patients. He does so by describing his own maladies -- his ADD and shopping addiction -- which he analogizes to severe drug addictions. Fair enough. It IS important to recognize our common humanity (although some think that as a successful middle-class physician Maté is stretching this connection). But, for Maté, they are all brain diseases.

Beyond this, Maté has a theory of addiction rooted in childhood abuse. Maté combines his clinical experiences with brain research claiming the source of addiction is in formative brain chemicals. For Maté, the first five years of life (and even the environment in the womb) dictate the likelihood of addiction. He then relates this theoretical point of view to studies connecting stress, abuse and lack of love and attachment to not only life problems (as they have been for some time) but to deficiencies in people's ability to process endorphins and dopamine -- the neurochemicals in our bodies that provide us with both pleasure and pain relief.

Maté then claims that addiction results from deficiencies (lack of receptors) in these neurosystems that cause people with addictions to self-medicate to replace their missing neurostimulation. In this sense, people are addicted to drugs as replacements for the brain chemicals their own bodies fail to process. Those addicted to things other than drugs are reacting to the same internal chemistry, but with different external stimulants.

It is important to respect Maté's work with individuals living with addictions. For this reason, people who work with clients from a harm reduction perspective -- that is, they accept people as they are, and seek to help those in need -- deeply admire Maté. In addition, Maté's exploring the root causes of addiction may in some sense represent progress out of a deterministic disease concept of addiction because it broadens the range of experiences that can lead to addiction and through which addiction expresses itself.

Unfortunately, however, Maté is fundamentally proposing a reductionist vision of addiction, where abuse history and posited biochemical changes are now THE essential causes of people's self-destructive action. It is not enough to say that this model is highly conjectural. It also isn't true -- that is, it makes little sense of the data. Vincent Felitti conducted a huge epidemiological study on early childhood experiences. He found that only a tiny group (3.5%) of people with 4 or more adverse childhood experiences became involved in injection drug use. So Maté's model is highly undiscriminating. The percentage of addicts increases somewhat with the number of adverse experiences. Even so, this relatively minor elevation in no way presupposes the damage is caused biochemically, rather than simply by detrimental psychological consequences and deeply dysfunctional homes and environments.

One counterargument in favor of Maté's position might be that injection drug use is low among this population because so few people who have experienced abuse are exposed to injectable drugs. But this argument does not hold either. Felitti has included alcohol in his research. And, with drinking, the rates of dependence follow the same trajectory depending on the number adverse childhood experiences, but are still not much higher for abuse victims -- 16%.

Beyond this failure to find the distinct differences in addiction among abuse victims that Maté proposes, we must account for people's natural tendency to overcome abuse and addictive experiences. We might, after all, study what are the protective effects for the other 96.5 percent of abuse sufferers that prevent them from injecting drugs, and the 84% who do not become alcohol dependent. And, on top of this, what about the strong tendency that has been revealed -- time and again -- for people with addictions to naturally remediate. According to the National Institute on Alcohol Abuse and Alcoholism, three quarters of people who were at one time alcohol dependent fully recover, the large majority without treatment, many without ceasing to drink.

In fact, at the deepest level, Maté's views limit our approaches to, our understanding of, and even our respect for people living with addiction. Rather than expand our understanding of addiction, his views harm our ability to respond to it. For one thing, focusing solely on one risk factor and one very questionable source of addiction has led Maté to posit a potential ‘cure' for addiction -- Ayahuasca -- a brew made from South-American "spirit-vine" that is claimed to open the human conscious for a higher degree of introspection. In fact, Maté's reliance on this treatment further confuses levels of analysis -- does introspection really remedy the absence of neuro-receptors in some straightforward manner?

In this context, that harm reductionists embrace Maté is extremely troubling. For, contrary to popular beliefs in these circles, Maté is actually diverting the addiction field from a more comprehensive and practicable view of addiction. Maté's embrace of Ayahuasca does not support the broad harm reduction goals of expanding the resources available to people with addictions like those in Vancouver, of developing their skills for functioning in their worlds, and of holding up the hope that they can improve their lives. Instead, this approach is reductive, monosyllabic, and really no different than the disease camp's fool's gold quest for an addiction vaccine in the forlorn hope that we can remedy addiction without improving human lives.

A true harm reductionist should accept a wide range of contributors in the development of addiction, but particularly those that human agency -- and particularly the person who is addicted him or herself -- can address and improve. Without this sense, we are lost.

Q. I read an article you (Dr. Peele) wrote recently that questioned the validity of statements connecting addiction to early childhood trauma. How big a role, in your opinions, does early childhood experience play in later substance issues?

- Thanks for the question. I have been notably at odds with Dr. Gabor Mate lately, who is one of those who trace EVERY case of addiction back to childhood trauma. I oppose that for three reasons: (1) It's inaccurate: although abuse and trauma are bad for people, most addicts weren't traumatized as kids; most traumatized people don't become addicts; (2) I really disrespect how Mate goes from there -- if the trauma isn't apparent, then you search for it -- in which case it will always be found -- or else made up; (3) In Mate's hands (and he's one of many) it becomes a new disease theory -- since abuse and trauma aren't erasable (and Mate has these elaborate, Rube Goldberg connections proving they're imbedded in your brain) their addictive effects can never dissipate, which is (a) untrue, (b) unhelpful, and just one more burden against overcoming addiction. Our whole approach in Recover! is to emphasize the truth that most people leave addiction behind, and use that reality to inspire people.

- Thank you for your answer. I am very fond of your writing and Dr. Mate's, and I can see your point very clearly about childhood trauma being the new disease theory. It shifts somewhat from "disease" to "disability", which is, in my opinion, wonderful for erasing stigma, but not very empowering for the addicted person. I appreciate your response. I have been very curious about this. Thank you, again, Dr. Peele.

- That was a very constructive interaction around a highly contentious issue, which you summarized very nicely. Thank you.

Ashley Potter What confuses me about Gabor is that he seems to support both the disease theory and the self-medication theory of addiction and I'm not sure that I understand how they relate. How can addiction be a brain disease as well as an adaptation to stress and/or trauma. Also, given his interest in shamantic medicine and psychedlic cures, how does he suggest that rids one of a brain disease? What exactly does he believe ? I'm confused.

Stanton Peele Too, too true -- it's all the people who think he's a guru who are confused.

Stanton Peele has been at the cutting edge of addiction theory and practice since writing, with Archie Brodsky, Love and Addiction in 1975. He has developed the on-line Life Process Program. His new book (with Ilse Thompson) is, Recover! Stop Thinking Like an Addict and Reclaim Your Life with The PERFECT Program. He can be found online on Google+, Facebook, and Twitter.

1.Dr.Gabor does not put his addiction on the same level as an injection drug addiction. He puts it on a spectrum that includes overeating, shopping, excessive tv watching at one end all the way down to injection drug use.
2. He never posited ayahuasca as a cure. "The plant, and the experience with the plant, is no pancea. There are no panaceas. But as an opening to human possibility, even in the face of lifelong trauma and desperation, it offers much. Seeing people open unto themselves, even temporarily, has been a teaching and an inspiration." (http://hour.ca/2011/11/03/the-jungle-prescription/)

I believe Dr.Gabor really is trying to get to the heart of the matter. He has worked with addicts for at least 12 years.

I believe this article is dangerous. You are presenting a skewed version of the facts. In fact, it really feels like a personal attack against Dr. Gabor.

I hope you at least feel bad for trying to skewer someone doing such important work.

I think everyone would agree that brain development during early childhood and infancy is crucial to how we cope with our world and the people in it. Certainly there are plenty of addicts who were never abused, and plenty of abused people who are not addicts, but I don't think that takes away from a very important connection Mate is making. Here is a "for instance."
No one would describe it as "abuse" or even "neglect" if a highly stressed suburban mom had three kids, and without intent, was least attentive, least affectionate and most anxiety ridden with the youngest and last child who happened to be "a surprise." But, she would inadvertently pass on a message to that youngest child from his infancy her anxiety, which would in turn set up his brain chemistry and neurons differently. He is likely to start out with a propensity for addiction - a desire to self medicate, get his brain feeling good, feel less anxious and more accepted, more loved. So linking addictive behaviors to early experiences and the brain chemistry arising from those experiences seems absolutely correct. I think the author of this article is trying to make it seem like the whole idea is abuse equals addiction, but i didn't get that from Mate's book at all.

Certainly there are plenty of addicts who were never abused, and plenty of abused people who are not addicts, but I don't think that takes away from a very important connection Mate is making.

Agreed. And a related thought came to me when watching one of his youtube videos and reading this psychologytoday article (and comments).

As scientists, we have to create narrow definitions of these intangible concepts in order to measure them. However, when we think about them conceptually we shouldn't be bound by these definitions when our minds can think about them so much more richly.

For instance, this article cited research that tested the relationship between # of traumatic childhood expereinces and abuse and found null results. They concluded that Mate's claim is therefore invalidated.

But if Mate's proposed mediator is stress, then much, much more than simply "4 traumatic experiences" would account for its existence. How about the numberless chronic stressful situations that a child can experience that wouldn't be included in this measure? bullying, hunger, inattention, neglect, mirrored parental stress, etc.? ...As if controlling for poverty was the only other possible variable that might account for stress.

Certainly there are plenty of addicts who were never abused, and plenty of abused people who are not addicts, but I don't think that takes away from a very important connection Mate is making.

Agreed. And a related thought came to me when watching one of his youtube videos and reading this psychologytoday article (and comments).

As scientists, we have to create narrow definitions of these intangible concepts in order to measure them. However, when we think about them conceptually we shouldn't be bound by these definitions when our minds can think about them so much more richly.

For instance, this article cited research that tested the relationship between # of traumatic childhood expereinces and abuse and found null results. They concluded that Mate's claim is therefore invalidated.

But if Mate's proposed mediator is stress, then much, much more than simply "4 traumatic experiences" would account for its existence. How about the numberless chronic stressful situations that a child can experience that wouldn't be included in this measure? bullying, hunger, inattention, neglect, mirrored parental stress, etc.? ...As if controlling for poverty was the only other possible variable that might account for stress.

Thank you so much for your retort on the almost aggressive mis represented facts of Dr. Mate's work. It is unfortunate in this world when comments are made when the body of work is never read. If these scientific responses were made after reading even one of his six books, then I am saddened at the disconnect. His comments in the last chapter of "In the Realm of Hungry Ghosts" addresses what he believes is needed in changing the destruction of addiction on society. Simple truth.

It's unfortunate that google's web search optimization allows such a misinformed opinion to float to the top of a search query for someone like Gabor Mate. This article should post a retraction. The research that Vince Felliti did with the adverse childhood experiences was to map addictions and all disease later on in life that have to do with nervous system dysregulation. Nervous system dysregulation being the downstream affect of adverse childhood experience. The works of Dr. Stephen Porges and Dr. Alan Schore further contextualize this. You have unhealed trauma you will have disociative issues around stress. That will manifest as addiction, and many addictive behaviors that can't be easily linked to "substances", pain syndromes, and basically all forms of disease. This guy has pretty unsophisticated opposition to Dr. Mate and does a great disservice to science.

This article is an example of the issues in our society.. Competition, disconnection.. I hope that this author has the courage to experience Ayahuasca some day so that he can see things more clearly from his heart!

Thank you for defending dr. Mate. The article and author are obviously supporting the status quo. In the western medical system sick people are turned into cash cows as surely an array of pills will rid them of their symptoms! And of course, most importantly, make money off them and turn their conditions into chronic ones to continue profit from their misery.

Attack is what Peele is all about. I actually stumbled upon this article by accident as I stopped following anything Stanton Peele writes. His star shined, although not all that brightly, way back in 1973, and I believe he longs for those glory days. Although I can honestly understand a few of the points that Stanton is trying to make here, I whole heartily agree with you on the way he goes about making them. Then again, he does the same thing when talking about Alcoholics Anonymous and its "angry" members. You know what? I think I may read some of his latest posts and comment on a few of them as well. Maybe it's time for a former AA member like myself to help him understand why people get so angry at what he writes. Of course considering there is currently only my comment and yours here, maybe it's not worth the effort.

It was 1976 actually (Love and Addiction). And he has only had 11 more books published since then, advised on the substance abuse sections of the DSM, lectured at conferences and debates nationally and internationally...

Seems like quite a strange way to burn out....would hate to see what success looks like to you.

All right Alan here goes. His star "began" to shine, although not too brightly, way back in 1976 with his book "Love and Addiction." Since then he's written several other books, and in 1987 even appeared on the Oprah Winfrey Show. How's that for a correction? Listen, I agree that Stanton has had some success, define that as you may, but I never said he burned out. Heck, I even agree with some of the things he's written. The fact still remains that scholarly or not, Stanton Peele comes off like an angry old man, and this causes people to retaliate. I feel it's just not needed. I also feel that people active in the field of addiction should work "together" to help those with addictions. Attacks like the ones presented in this article, and yes my own small attempt at one in my previous comment, simply doesn't help anyone. I don't feel good about the way I responded, but I do stand by my statements, "he longs for his glory days" and "comes off like an angry old man." It explains his attack of others, and the nasty way he responds to people who disagree with him. Then again, after watching him on Oprah, I think he may have been an angry person for a very long time.

What I don't understand is that Peele says most addicts surmount their addiction without assistance, and therefore (and here's my confusion) those who do require assistance shouldn't and are wasting their time?

After reading Stanton's bio on here, I realized Gabor is stealing his thunder. Stanton might have had the whole "social-environmental" causes of addiction idea first. Even so, it is pretty sad to try to paint Gabor as a total quack.

I don't think Stanton was the first to propose the social/environmental connection, either. In particular, the work of John Bowlby and his exploration of family systems and attachment theory explored the links between early childhood experiences - Bowlby's "Separation: Anxiety & Anger" came out in 1973.

After reading Stanton's bio on here, I realized Gabor is stealing Stan's thunder. Stanton might have had the whole "social-environmental" causes of addiction idea first. Gabor is really popularizing it. Even so, it is in bad taste to try to paint Gabor as a total quack.

I am a therapist in Vancouver. Although I have never met Dr. Mate personally, I have read a couple of his books and seen the positive impact of both of them. Yes, his treatment is risky...however, addiction is a risky field. What he seems to have in his favor is a caring and compassionate relationship with those he treats. That goes a long way with me...

I believe if we add too many "causes" for addiction then we over-stigmatize it. Now if someone is to admit they have addiction, then must their peers assume they are abused as well? Or have a mental illness? Or a personality disorder?
I have so many patients who have nothing but the addiction itself, especially if I meet them early in their process.
I love it when people, perhaps this Dr. as well, when they bring the honesty and intensity of their addiction story to the stage to help others. But don't forget that I am not everyone and everyone is not me. Don't tell me why I am the way I am...ask me.

For many, doubt created fears and insecurity is at the heart of whatever dependency they may have. True, many people stop using drugs or alcohol on their own and go about living life as they see fit, however, some people need help. Either way, life is about trying to find happiness and security in our environment, and learning to be happy and secure with ourselves. For me, it took nearly eight years of my sixteen years sober to find happiness, and a level of love for myself through the help of AA and The 12 Steps. The last eight years has been spent finding greater happiness in life on my own, and learning to love myself unconditionally. Today, I am happy with who I have become, and it doesn’t matter to me how others get sober. What does matter to me is making sense of addiction through science, and not criticizing anyone or anything that can help someone overcome a substance dependency. Science has proven Stanton Peele wrong with its findings on neurotransmitters, information on the old brain/new brain, the knowledge of the reward/reinforcement pathway, and brain imaging technology. This doesn't mean that harm reduction isn't an alternative for some people, but it also doesn't rule out environment factors and genetics. Trust me, fears and insecurities, whether from childhood traumas or events later on in life, can and does affect our brain chemistry. Our thoughts make up our lives to a great degree, and if we have a predisposition to addiction, the combination of biology, psychological factors, and even social factors can cause some of us to use a substance to try and find happiness in life. Unfortunately, over time it can change our brains to the point that it can actually end up killing us. After that, I’m not so sure it matters anymore why we chose to use a substance.

the combination of biology, psychological factors, and even social factors can cause some of us to use a substance to try and find happiness in life.

I disagree with most of what you have written apart from this quote. So you are onside with a biopsychosocial model of addiction? If so, can positive psychological and social factors protect against biological changes in the brain caused by adverse childhood experiences? Something must be keeping the majority of people with high ACE scores from developing an addiction...nobody seems to want to comment on this here though.

In addition, we aren't suggesting that adverse childhood experiences are not a risk factor for addiction, it just seems that other factors (as you point out) most likely need to be in place for addiction to occur. What else would account for the low rates of dependence?

And the danger that we speak of comes in the take away message that adversity in childhood = addiction, and that intractable changes in brain chemistry now govern our behavior and choices. When people buy into this way of thinking it can cause a hopelessness that keeps people stuck, much in the same way that buying into the disease model can have the same effect.

"can positive psychological and social factors protect against biological changes in the brain caused by adverse childhood experiences?...nobody seems to want to comment on this here though."

Protection against "adverse childhood expierence" is upbringing. Anyone has had this stuff. Thats why there is culture.

The US and most of the western countries HAS HAD a specific type of neurotics called "alcoholics". Only with the hard work of some "alcoholics anonymous"-freaks the broad public and science came to SOME understanding: The biopsychosocial model of LATE-STATE GAMMA-style "alcoholism". The biopsychosocial model is past-oriented - it just illustrates what HAD happened to the drinker, why he has got all the problems he's talking about.

Thats a disease in terms of modern psychology and addiction is not. I had no words but maybe this example will work:

Social Phobia is a phobia. Phobia is not a "personality dissorder" (called dizzy order hereafter).
Dizzy orders like Cluster I "Schizotypal" dont know how to manage social contacs, "Schizoid" dont like to manage social contacts. Cluster III (Active-)"Avoidend" dont dare to have social contacts.

One the hand you got a symptom, on the other hand you had to treat them different.

Second
Is it possible to treat "addicts"? Yes, but its in terms of re-edducation - IE a forensic setting.

Back to your remark: "nobody seems to want to comment on this here though". The answer is in the mere structure of DSM-III to IV. Dizzy orders occur in age 14-18.

There is no gene to alcoholism and brain scans can prove that.
There is no early trauma that causes addiction but brain scans can hardly prove that.

THERE IS NO "CHILDHOOD TRAUMA" AS SUCH. Its a fucking trick to get people struck.

You got "them" at the balls buts that one will be a dirty fight, good luck.

I'm not surprised you disagree with most of what I wrote, I see by what you wrote in your reply that you're a fan of Stanton Peele. Thanks for agreeing with me on something though. Also, thanks for being civil. No matter what I profess to believe about addiction, the bottom line for me is being emotionally well while sober. Part of being emotionally well is not getting involved in comment threads like this, and yet here I am. :) My message is a simple one. I'm not perfect, (see my reply above) and I certainly don't pretend to have all the answers to addiction. However, knowing this helps me to be open minded, and keeps me on a path of personal and spiritual growth. I simply wonder about people who do claim to have all the answers, and don't, or can't admit to their imperfections. I will say this, however. It's been proven that over time a negative and harsh environment can change a person's brain chemistry just like a substance can. As this imbalance continues, by shear definition it can be considered a disease. Whether I had a disease because of drinking can be debated, but I simply don't care today. When I stopped drinking, I slowly changed the way I thought, and as my brain became more chemically balanced, I was able to be happy without using a substance to do the trick. You mentioned hopelessness. In my drinking days, besides the fears and insecurities I felt, I also often had a sense of hopelessness about things in my life. I don't feel hopeless about anything today. I do feel I have spent far too much time commenting and replying to this article though. :) Take care, and thank you for your input Alan.

I see by what you wrote in your reply that you're a fan of Stanton Peele.

Not just a fan...also co-author of the article...some of the ideas above are my own.

It's been proven that over time a negative and harsh environment can change a person's brain chemistry just like a substance can.

Agreed...we don't dispute this, we dispute the argument that brain chemistry changes, on their own, cause addiction. A major risk factor, yes, but risk and causality are two different things.

As this imbalance continues, by shear definition it can be considered a disease.

Acquired brain injury can cause imbalances in reward circuits in the brain, can cause a super-sensitivity to psychoactive substances and can put individuals with ABI at a higher risk for substance abuse. Does this mean that ABI is a disease?

From what I see, the debate over whether or not addiction should be called a disease will go on for quite some time, but at least Stanton Peele has the answer. Let me clarify something. I don't care what we call it. My strong point is helping those who want to get sober and remain that way. Many people do it on their own, and some use alternatives other than AA, but it really doesn't matter how someone gets sober. What does matter is finding a way to prevent as many causalities as we can that come from addiction. We can argue what to call it all day, but what if everyone joined together in prevention? Disease or not, the underlying reason why someone abuses a substance is where we need to focus. Honestly, I think you and Stanton Peele may truly be a helpful influence in the field. All I was trying to say through all of this is that I disagree with how Stanton Peele goes about presenting his views. To answer your question, no I don’t think ABI is a disease. But then again, I never said addiction is a disease. I simply said it is considered one by sheer definition. I guess we could change the definition of disease, and while we’re at it, we could also change the term alcoholic. I currently call myself a “recovered” alcoholic, but I was more of a problem drinker than anything else. Although I never hit any kind of “rock bottom,” and lost everything, I did meet at least three of the criteria for Substance Dependency in the DSM-IV. I can go on talking about definitions and terminologies used to describe substances and dependency, but once again I don’t care how people define addiction, or what they call it. Science tells me at least for now, that when we look into the workings of the brain in relation to addiction, the term “brain disease” does come to mind, no pun intended. On a different note, science also tells me there may be a chance that something created life and the universe for a reason, but I know Stanton Peele has the answer to that too.

From what I see, the debate over whether or not addiction should be called a disease will go on for quite some time, but at least Stanton Peele has the answer.

Hate to tell you this but the ship has sailed on that one already...according to the NIAAA, Gabor Mate, Vincent Filetti, Bill Miller, Herb Fingarette, Alan Marlatt just to name a few, all have researched and written about the abject lack of evidence for the disease model. Not just Stanton. Did you even look at any of the links we posted?

but once again I don’t care how people define addiction, or what they call it.

I do care about how people define and label addiction...an accurate understanding of addiction is incredibly crucial from a policy, prevention and treatment perspective. It's the whole point of this post (that you seem to have overlooked).

Science tells me at least for now, that when we look into the workings of the brain in relation to addiction, the term “brain disease” does come to mind

And at one time when people looked into the workings of the earth the term 'flat' used to come to mind. Until we started to actually listen to science of course.

Seems Mr. Crudmore has learned well from his mentor Peele: in addition to being wrong and misciting and misstating others, be sure to be personally insulting, rude and provocative. Engage in ad hominem attacks to incite anger and resentment, as though that's the goal.
Sad but you learned well.

I agree Ouch! Like the user name by the way. I have a response to Alan's reply to me, but I'm thinking it's useless to even post it. I probably will later though. :) I tell people to let Google be your friend when it comes to finding out a more accurate truth about something. There is definitely a lot of research to back up the idea that addiction is a disease, and I have the URL’s to prove it. :) I remarked that I don’t care how people define addiction, or what they call it, however, I didn’t say it doesn’t matter from a policy, prevention and treatment perspective. I look at addiction and how we should help others from a very simple perspective. When someone is in recovery, the best way to help them is to not argue about what the definition of addiction should be, or what it should be called. The best way to help someone is to gain their trust by being an example of a happy and loving person, and also an example of someone who doesn’t feel the need to be right about everything. I’m someone who has “recovered” from the underlying reasons of why I drank, and I’m also someone who has a found true happiness in life. What I’m not is personally insulting, rude and provocative, nor do I care to engage in attacks to incite anger and resentment. I did enough of that in my drinking days.

From another attendee in Edinburgh who had the displeasure of being in a room with Peele, the great Provacatuer:

"Cheeky is one thing, but flipping through one’s power point and interrupting the other person whilst the other person is talking is plain rude. Whenever a point was made against Peele’s theory/argument, he neatly glossed over it in favor of his position.

Additionally, purposely making blanket statements without research to back it up isn’t recommended (“AA kills more people than it helps.”) and talking about one’s own treatment center when providing many examples is arrogant in the least. Are other people doing it? Are they not doing it because it doesn’t work? Why aren’t you mentioning others employing this method/research you talk about in treatment settings if it does work? Also, “a 24 year old will never stay sober.” Peele, you’re dead wrong. I know of plenty of young 20-year-olds and people even younger that have. Stop making such ridiculous statements that aren’t backed up by research."

Oh, the debate is over and People agree with Peele? What are you smaking Crudmore?

"Although AA was instrumental in again emphasizing the "disease concept" of alcoholism, the defining work was done by Elvin Jellinek, M.D., of the Yale Center of Alcohol Studies. In his book, The Disease Concept of Alcoholism, published in 1960, Jellinek described alcoholics as individuals with tolerance, withdrawal symptoms, and either "loss of control" or "inability to abstain" from alcohol. He asserted that these individuals could not drink in moderation, and, with continued drinking, the disease was progressive and life-threatening. Jellinek also recognized that some features of the disease (e.g., inability to abstain and loss of control) were shaped by cultural factors.

During the past 35 years, numerous studies by behavioral and social scientists have supported Jellinek’s contentions about alcoholism as a disease. The American Medical Association endorsed the concept in 1957. The American Psychiatric Association, the American Hospital Association, the American Public Health Association, the National Association of Social Workers, the World Health Organization and the American College of Physicians have also classified alcoholism as a disease. In addition, the findings of investigators in the late 1970s led to explicit criteria for an "alcohol dependence syndrome" which are now listed in the DSM IIR, DSM IV, and the ICD manual. In a 1992 JAMA article, the Joint Committee of the National Council on Alcoholism and Drug Dependence and the American Society of Addiction Medicine published this definition for alcoholism: "Alcoholism is a primary chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, mostly denial. Each of these symptoms may be continuous or periodic."

.......
Alcoholism should not be judged as a problem of willpower, misconduct, or any other unscientific diagnosis. The problem must be accepted for what it is—a biopsychosocial disease with a strong genetic influence, obvious signs and symptoms, a natural progression and a fatal outcome if not treated. "http://www.physiciansnews.com/commentary/298wp.html

Obviously, many do not share Peele's opinion. He simply calls them names...a bit like you Mr. Crudmore...

Mr. Cudmore seeks to argue that Jellinek's disease model of alcoholism is invalid because many folks recover from some stage of alcoholism without much help.
He is wrong. He's just oversimplifying and misstating Jellinek's ideas in order to parrot Peele's mean spirited attacks.
How about:
" E. M. Jellinek is regarded by many as the father of the modern disease model. His research produced two major constructs, the stages of the disease and the species of diseases. The stages of the disease had a major impact on how alcoholism (and addictions in general) were viewed. According to his theory there are four stages in alcoholism, pre-symptomatic stage – no problems with alcohol; prodromal stage – characterized by blackouts (amnesic episodes), guilt and increasing drunken episodes; crucial stage – characterized by failed attempts at controlling use, loss of willpower; and the chronic stage – mental and physical complications and increasingly lengthy binges. Many of these symptoms can be seen in heavy drinkers but Jellinek distinguished heavy drinkers from ‘real alcoholics’ by their ability to control their drinking (ie stop at will or decide whether or not to drink).
Jellinek suggested that although there were exit points at each of these stages (ie the alcoholic could stop drinking) the majority of alcoholics would continue to the chronic stage. It was at this stage, when physical and mental damage had occurred that change would be most likely to occur. "

So, Jellinek's work and disease concept is entirely consistent with the observation that some slef reported folks with alcohol problems recover without help. That does not mean alcoholism is not a disease.

Didn't oversimplfy or overstate anything. I challenged the methodology that his assumptions were based on. As have others, such as Herb Fingarette:

"Jellinek's highly influential articles were based on questionnaires completed by 98 male members of AA...Jellinek also excluded all questionnaires filled out by women because their answers differed greatly from the men's...Even in 1960, Jellinek acknowledged the lack of any demonstrated scientific foundations for his proposal. Of the lack of evidence he remarked, 'For the time being this may suffice, but not indefinitely'"

- Herbert Fingarette (1988) "Heavy Drinking: The Myth of Alcoholism as a Disease"

Even the NIAAA in the link I posted indicates that you can't base our understanding on small, in-treatment populations:

“As is so often true in medicine, researchers have studied the patients seen in hospitals and clinics most intensively. This can greatly skew understanding of a disorder..."

Those 98 aa- members rip the fucking pamphlet apart to send the questinaire back - in order to save others. The questinaire was pafe 8 of the "Grapevine"-magazine. In other words - to help others was more import but their shit club !

Jellinek was the first to call the aa a shit-club in 1959 - for good reasons. But Jellinek wasn't ever a lame social psychologist but a scientist. The so-called Jellinek-Curve" was and is both wrong and stupid. But w/ over 2.000 stories to back it up from 1946-1960 his studies are important on TWO crucial axes.

What looser perspective is this?
You mix it all up. FE Jellinek was in math/stats first. Its that simple feature called scientific method that Bill Wilson DOES follow that makes the "BigBook" a breakthrough. The very method.

On the other side - the political agenda. Do ya really think you can trick the public in the long run ?

I completely disagree with what Mr Stanton Peel has said about Mr Gabor Mate. In fact im angry and not happy about it at all.
I myself suffer from alcohol addiction but not drugs.
I can relate 100% with Gabor Mate about my childhood etc etc.
I agree this may not be the case in all people but with ME Gabor realy hit home and in such a way that i could understand and put the pieces together.
The thing is, so much medical evidence has been hidden from the general public and for so long that we just don't know the REAL facts.
Now with the internet... ordinary folk are able to get that information at the click of a mouse button.
AND some people and writers DON'T like it.
I for one admire Gabor for his work and he has helped me a lot where other 'Professionals' have failed miserably. If he has helped just a few people then thats a good result not a bad one.
How can ANYONE critisize someone for trying to help other people?
The first poster summed it up better than me and i could'nt agree with him more.
I think anyone that is prepared to help others deserves applaud. Mr Stanton Peel really needs to get a grip on what actually helps people instead of what HE THINKS might help people.
Theres a massive difference.

Psychology has not been the focus of my earthly career, and as a result I am not victimized by the jargon of this pseudo-science.

A significant point of agreement I have with Mate is that our brains are shaped by our experience. Our socialization is responsible for our attitudes and our addictions. What can be described as "adverse experiences" are not confined to our childhood and our neural orientations are affected by all of our experiences. I believe Mate also accepts this or he would not be running a clinic.

His critics here seem to want to put him in a box as a simpleton with a far out theory of the human psyche. There IS such a thing as organic brain disease. Addiction however is usually a result however of factors of socialization. That is the root of the problem.

It appears to me that the blind professionalization, certification and dogmatism, not to mention the commercialization of the psychiatric and psychological community has deeply harmed effors (such as Mate's) with unwarranted self serving criticizms.

[Mate]does so by describing his own maladies -- his ADD and shopping addiction -- which he puts on a level with severe drug addictions.

It is obvious that he has not read Mate's book, or even looked particularly carefully at anything Mate has said first hand. Mate goes to great lengths to qualify his shopping addiction as being less disastrous than other addictions. His argument is that many addictions have the same underlying psychological causes, varying in severity. In Hungry Ghosts, he writes his addiction "wears white velvet gloves" compared to his injection drug addict patients. Watch his interview on addiction with Democracy Now, and he makes the same qualification.

Dr. Peele chooses to ignore the subtleties of Mate's views, in order to make him seem reckless and naive. Another example: Mate is not trying to push Ayahuasca on every addict in North America. He is not hyping it as the cure for everything. He is saying that it should be legal to run clinical trials on it's effects in treating addiction.

As a fan of Dr Mate's, I'd greatly appreciate reading an honest and thoughtful critique of his views, but I'll have to find it elsewhere.

i have no scientific evidence to prove GM is correct, i am not a scientist. however, i am a former NA member, and spent 15 years of my life as a drugaddict. "in the realm of hungry ghosts" felt so true and managed to give me the missing pieces to the puzzle of why i wasted my life for so many years. most of it i had somehow "felt intuitively", but reading his book i found the language to express this better. i have recommended it to several friends who've felt the same way.

i had no idea GM recommends some brew to open up for a "higher degree of introspection". and, i might be dense, but i dont see the contradiction to what peele propagates and GM's thoughts and theory, except for this part about the brew.

GM view of addiction is not reductionisitic compared to common way of perceiving addiction; lack of willpower, morals etc. especially for those of us who've been serious heroin-injecting drugaddicts, the lowest of the lowest, it feels great to be taken seriously about how damaging severe childhood trauma can be.

peele also simplifies the results of the ACE studies. yes, it is true not everyone who've been abused becomes drugaddicts. BUT it all depends on so many other socio-economic parameters as well, for example; did you have at least one family member who supported you? did you connect with a teacher at school, etc etc.

like i said, i dont have anything but anecdotal evidence from my own years as a drugaddict and everyone else i knew who had a drugproblem, but its all in line with what GM has written.

another excellent writer is dr bruce alexander "the globalization of addiction". its more of an academic book, not as pop-sciency as GM and he totally supports GM writings. as does Robert Flores also, in the book "addiction is an attachment disorder".